[CIS PIDD] [cis-pidd] Severe aphthous ulcers in an adolescent with CVID

Thu Jun 5 10:08:06 EDT 2014

You might try Debacterol <http://www.debacterol.com/prof_ci.html>. I agree
with Ken, the lesion should be biopsied.
Richard Wasserman

On Thu, Jun 5, 2014 at 6:57 AM, Leiding, Jennifer <jleiding at health.usf.edu>
wrote:

>  We have a similar patient with Hyper IgM syndrome and neutropenia,
> responding well to Neupogen but continues with persistent severe apthous
> stomatitis. Any suggestions?
>
>
>
> Thanks,
>
> Jennifer Leiding
>  ------------------------------
> *From:* Elie Haddad [elie.haddad at umontreal.ca]
> *Sent:* Thursday, June 05, 2014 9:08 AM
> *To:* CIS-PIDD
> *Subject:* Re: [cis-pidd] Severe aphthous ulcers in an adolescent with
> CVID
>
>  Interesting.
> Jane, did you try Colchicine ?
> Elie
>
>
>    Elie Haddad, MD, PhD,
> Professor of Pediatrics, University of Montreal,
> Head, Pediatric Immunology and Rheumatology Division,
> CHU Sainte-Justine, 3175 Cote Sainte-Catherine
> Montreal, QC, H3T 1C5, Canada
> Ph: 1 514 345 4713
> fax: 1 514 345 4897
> e-mail: elie.haddad at umontreal.ca
>
>
>
>
>
>  Le 2014-06-05 à 09:01, Monica Lawrence a écrit :
>
>  Hi Jane,
>
>  We recently submitted a case report of using high dose (1-2 g/kg/month)
> IVIG successfully for the treatment of refractory recurrent aphthous
> stomatitis in a previously steroid-dependent 3 year old boy (without
> CVID/other immunodeficiency).   He had difficulty tolerating the high dose
> IVIG so we switched to SCIG (250 mg/kg/week) and he has been successfully
> maintained on this therapy for >1 year now without need for any other
> therapy.   So, you may try increasing the dose/frequency of your IVIG and
> see if the ulcers also improve.
>
>  Best,
>
>   Monica G. Lawrence, MD
> Assistant Professor of Medicine
> Department of Medicine
> Division of Asthma,Allergy & Immunology
> University of Virginia
> PO Box 801355
> Charlottesville, VA 22908
> 434-243-6811
> ml4nz at virginia.edu
>
>
>
>
>
>
>
>  On Jun 5, 2014, at 2:21 AM, Jane Peake <j.peake at uq.edu.au> wrote:
>
>   Hi all
>  I have a young girl with CVID who has been plagued with severe disabling
> aphthous ulcers for many years. Since starting on IVIg her infectious
> problems have largely resolved and her ulcers are better but they are still
> problematic. She gets them on her tongue, buccal mucosa and roof of the
> mouth and when she has them she finds eating and speech very difficult.
> Episodes are intermittent but she rarely goes more than a couple of weeks
> without a severe episode. She has had a couple of episodes of labial
> lesions but since starting doxycycline (on the advice of the
> gynaecologists) she has only had one episode when they had run out of the
> doxycycline. We have tried a variety of topical treatments – local
> anaesthetics and steroids. She responds well to oral steroids but these
> cannot be used regularly. Does anybody have any other ideas in this setting?
>  Thanks for any suggestions
>  Cheers Jane
>
>  Dr Jane Peake
>  Paediatric Immunologist and Allergist
>  Senior Lecturer
>  University of Queensland
>  level 3 Foundation Building
>  Royal Children's Hospital
>  Herston Rd, Herston QLD 4029
>
>
>
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-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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